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BodyBody--Surface Electrocardiography Variations Caused bySurface Electrocardiography Variations Caused by Changes in Cardiac Geometry Due to Diabetes and ObesityChanges in Cardiac Geometry Due to Diabetes and Obesity
 

Summary: BodyBody--Surface Electrocardiography Variations Caused bySurface Electrocardiography Variations Caused by
Changes in Cardiac Geometry Due to Diabetes and ObesityChanges in Cardiac Geometry Due to Diabetes and Obesity
AbstractAbstract
Purpose: Myocardial disease is common in the diabetic, including elevated risk for myocardial infarction,
heart failure, and sudden cardiac death. Both diabetes and obesity, which is common among diabetics,
are responsible for deleterious electrophysiological and geometric changes to the heart. Here we
investigate the effects on body-surface electrocardiograms (ECGs) of changes in cardiac geometry
associated with both diabetes and obesity. Left ventricular hypertrophy (LVH) has been found to occur
among diabetic and obese groups. Additionally, heart position and orientation can change inside the
obese torso. To quantify effects of these geometric changes, we modified the realistic heart and torso
models of the simulation package ECGSIM (http://www.ecgsim.org/)[1] as input to our bidomain forward-
problem solution.
Method & Materials: To simulate LVH effects, both the inter-ventricular septum (IVS) and the posterior
wall (PW) of a normal heart model were increased 5% (LVH5), and 20% (LVH20) for the diabetic and
obese cases, respectively. Values were selected to match measured increases in the thickness of the IVS
and PW of 2-9 and 1-8%, respectively, in diabetic patients [2]. In the obese group, IVS and PW increases
of 11-22 and 13-25%, respectively, were seen [3]. To simulate the obese heart displacement, the heart
was shifted (8% of the torso height) and rotated (6, 4.5 and 28 degrees in the coronal, frontal and sagittal
planes). These values were taken from experimental measurements on normal and obese subjects made
by our group. A bidomain forward-problem model was used to calculate ECGs from cardiac

  

Source: Arthur, R. Martin - Department of Electrical and Systems Engineering, Washington University in St. Louis

 

Collections: Biology and Medicine; Engineering